Evidence

There is a growing body of research about the positive impacts CHWs have in reducing health disparities, expanding access to coverage and care, improving quality, increasing health care cultural competence, and controlling costs.

Many employers are particularly interested in the financial benefits of CHW strategies related to overuse, underuse and misuse of health services. Successful examples include reduction in preventable hospital readmissions as well as avoidable emergency room visits. In addition, increasing the appropriate use of primary care and preventive services can lead to early detection and timely treatment of potentially costly health conditions. And as care systems and local public health agencies shift to team-based models, the introduction of CHWs can improve health care cultural competence, increase patient satisfaction and demonstrate a sustainable staffing model where everyone is working at the top of her/his license.

See the following articles on CHW cost-effectiveness and ROI and check out our bibliography and research matrix to learn more.

Community Health Worker Cost Effectiveness Studies

Social Return on Investment: CHWs in Cancer Research: Wilder Research Center’s 2012 cost-benefit analysis of CHW services in cancer outreach found that for every dollar invested in CHWs, society receives $2.30 in return in benefits, a return of more than 200%.Download it here.

Return on investment from employment of CHWs: Author Carl Rush points out that there is a growing body of published research on the effectiveness of CHWs but that much of the evidence of CHW costs savings is still unpublished. He emphasizes in his 2012 article in the Journal of Ambulatory Care Management that ROI analysis for CHWs must consider a range of CHW roles and stakeholder points of view. Read it here.

The Effectiveness of a Community Health Worker Outreach Program on Healthcare Utilization of West Baltimore City Medicaid Patients with Diabetes, with or without Hypertension: shows that a CHW intervention program resulted in average savings of $2,245 per patient, and a total savings of $262,080 for 117 patients, along with improved quality of life.

Measuring Return on Investment of Outreach by Community Health Workers: a Denver Health study of 590 men in a CHW case management intervention shows increased use of primary and specialty care, and reduced use of urgent care, inpatient and outpatient behavioral health care use. The return on investment (program costs vs. overall reduced costs of care) was 2.28:1.

A Community-Based Asthma Management Program: Effects on Resource Utilization and Quality of Life: a CHW asthma intervention in Hawaii shows a decline in emergency room visits and increased quality of life. In one phase of the study, asthma-related per capita charges decreased from $735 to $181.

“The major goal of CHWs is to influence behaviors of diverse and underserved populations toward health outcomes through prevention and navigation of the health system. CHWs generate significant positive impacts in communities where they work…. Many of these changed behaviors have economic consequences for patients, families, caregivers and taxpayers. These economic impacts accrue in terms of savings in health care costs due to more efficient use of the health system, or increased labor productivity of healthier patients.” – Wilder Research Center, 2012